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General NPI Number Information
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NPI Number | 1942767959
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Entity Type | Individual
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Provider Name | ALLISON KATHLEEN MILLER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/26/2019
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 10332 OLD OLIVE STREET RD UNIT 100
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City | SAINT LOUIS
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State | MO
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Zip | 63141-5922
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Country | US
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Telephone | 314-567-4707
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Fax |
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Provider Business Mailing Address
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Address Line | 4852 DALTREY CT
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City | SAINT LOUIS
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State | MO
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Zip | 63129-1655
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Country | US
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Telephone | 314-973-3954
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 2019005245
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License Number State | MO
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